Tag Archives: shoulder pain

UP CLOSE AND PERSONAL WITH JULIE GLADDEN BARRE, MD

We are so proud to introduce you to Orthopedic Surgeon, Julie Gladden Barre, MD.  Dr. Barre has a specialty in Sports Medicine and treats all ages from high school athletes to  couch potatoes to weekend warriors to professional athletes. You may find her professional bio on our website, however, we wanted to  spend a few minutes with Dr. Barre and get to know her on a more personal level.  Read about it here:

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What inspired you to become a physician?

Since I was very young I have always had compassion for those in need and this carried into my initial professional calling as a physical therapist. I loved helping people who had been through an injury or surgery and eventually when drawn into management, my love of patient care continued to lure me back to hands on treatment of those in need. I then decided to return to school and become a physician.

Why orthopedics?

With my unique background as a therapist I understood the process of those who were injured requiring surgery and the often grueling process required to get back to what brings someone joy in life. The human body and the increasing active lifestyle of people in today’s world is what has always fascinated me and propelled my love of Orthopedics.

What do you love most about your job?

I love meeting people every day and finding out about their lives and occupations. My job is so satisfying and I thoroughly enjoy being able to help get people back on their feet again as well as help them get back to their normal activities of daily living or get back on the field or golf course or tennis court.

What is your biggest challenge?

One of the hardest things to deal with in the field of medicine is when tragedy happens and seeing people go through physical and emotional pain. As a physician it is hard not to feel the pain that patients and their loved ones go through. I like to encourage my patients and establish a team approach so that I am with them every step of the process.

If I weren’t an orthopedic physician I’d be a_______.

I can’t imagine not being a physician, however if I had to choose something it would be a chef. Everyone loves food and I thoroughly enjoy pleasing people through creativity in the kitchen.

Your proudest / happiest moment?

I think my proudest and happiest moment is when I had my son during the 4th year of my orthopedic residency. Residency is a grueling time in life and after going through a full 9 month pregnancy during residency, the morning my son was born was one of the most joyful times in my life.

Where is the most interesting place you’ve travelled? Why?

Guatemala. I helped a medical team during a medical mission trip in college and I was so moved by the people in Central America and how grateful they were for the medical care they received.

Any hobbies? Activities?

Beach activities with family, cooking, travel, attending sporting events, exercise.

 What’s your next adventure?

I would love to take a trip to Europe with my family someday.

Your guilty pleasure food?

A really good coffee and French pastry.

Dr Barre is aligned with the mission of Sarasota Orthopedic Associates to get her patients back on their feet, back to work, back in the game, and back to life.  SOA has three locations and offers same day or next appointments when needed. Check the website at www.SOA.md or call 941-951-BONE (2663) for more information.

Meet Steven Page, MD – Sports Medicine Physician

Throughout last year we profiled all our physicians here at Sarasota Orthopedic Associates in a series of interviews. We were pleased to have Steven Page, MD join our SOA group late last year as  Board Certified Orthopedic Surgeon and Sports Medicine Physician.  This week, we posed those same questions to him so you might get to know him better.

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Dr Page, what inspired you to become a physician?

When I was in high school, I injured my ankle playing soccer. I went to see an orthopedic sports medicine doctor. He took great care of me and led me through a rehabilitation program that got me back to playing quickly so I didn’t have to miss the season.   I loved playing and being around sports.  I knew then I wanted to be a sports medicine doctor so I could take of people the way he took care of me.

Why orthopedics?

I really like that we can actually fix problems and get people back to doing the things they like to do.

What do you love most about your job?

I love that my patients are really motivated to get back to what they enjoy. When patients are engaged in their own care, we work together like a team to accomplish their goals.

What is your biggest challenge?

Finding a way to spend as much a time as I can with every patient while not making the next patient I see have to wait.

If I weren’t an orthopedic physician I’d be a __________________.

A veterinarian. I have two boxers and I absolutely love animals.

Your proudest moment?

A college football player that I did a knee surgery on during my fellowship is still playing in the NFL over 10 years later today. I am proud that I had a small part in enabling his success.

Where is the most interesting place you’ve travelled? Why?

My favorite place visited is Maui, Hawaii. You can be on top of a volcano that looks like a Martian landscape in the morning and scuba diving with sea turtles in the afternoon.

Any hobbies? Activities?

I love to play sports and enjoy skiing and scuba diving. I get injured a little easier now as I get older so it helps me relate to my patients.

What’s your next adventure?

Becoming a father. I trained for years to be a surgeon, but I am totally unprepared for this.

Your guilty pleasure food?

French fries and macaroni and cheese. And I don’t feel guilty about it all!

Tablet with the text Sports medicine on the display

Whether you are a weekend warrior, professional athlete, or just a regular couch potato who overused those muscles and bones,  Dr Page sees patients of all  walks of life and all ages from pediatric to geriatric. If you’d like an evaluation, call 941-951-2663 or schedule an appointment with us online through our web page at www.SOA.md.   We have three locations and offer same day appointments. To keep up to date on everything at Sarasota Orthopedic Associates “like” us on Facebook HERE, or, follow us on Twitter HERE.

SHOULDER INJURIES IN GOLF

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Shoulder injuries are common in golfers. Stresses on the shoulder are different from other sports because each shoulder is in opposition when swinging the club. The forward shoulder stretches across the body with the trailing shoulder raised and rotated. This leads to different complications in each shoulder.

In addition, the rotator cuff muscles are placed under stress as they are a major force in providing power and control of the swing. The leading, non-dominant shoulder is most commonly injured. It is placed into an extreme position during the backswing causing impingement, or, pinching of the rotator cuff. This condition causes inflammation and rotator cuff tears. The placement may also put stress on the shoulder joint and cause tears of the labrum (a stabilizing structure in the shoulder).

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Pain may be felt in the shoulder or upper arm at various phases of the golf swing, or following play, often when the arms are overhead or at night. Injuries to the shoulder may be sustained from a poor golf swing, a mis-hit, or from overuse. Golfers can develop tendinitis and tears in the rotator cuff from a combination of poor mechanics and the repetitive motion of the golf swing.

Prevention

While many golf injuries occur due to a combination of overuse and poor technique, a lack of conditioning and flexibility also contribute to injuries and pain. Tips:

  • Rest between playing to prevent overuse injury.
  • When in discomfort, decrease the amount of time you play.
  • Shorten your back swing and turn more through the hips & waist.
  • Refine your swing to decrease force on the shoulder joint; pro lessons will help.
  • Exercise when not on the course to improve flexibility.
  • Warm up with brief cardio and stretching to decrease injury.

Treatment

  • Shoulder pain should be treated initially with rest or decreased playing time.
  • It’s best to completely avoid playing until pain is resolved.
  • Nonsteroidal anti-inflammatory drugs may be helpful over a brief timeframe.
  • Icing over 24-48 hours may support relief.
  • Range of motion exercises should improve flexibility.
  • If pain persists beyond 7-10 days, consult your physician.

A sports medicine physician can examine the shoulder and obtain x-rays or an MRI to determine the cause of injury. Most injuries are treated with rest, anti-inflammatories, and/or physical therapy. Bursitis and tendinitis may be treated with a cortisone injection. For pain that continues despite a thorough treatment program, surgery is an option to consider. Recent advances in arthroscopic surgery allow repair of most injuries through minimally invasive techniques, enabling quick return to your game and minimizing downtime.

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Steven Page, MD is an Orthopedic Surgeon with a specialty in Sports Medicine at Sarasota Orthopedic Associates. He is Fellowship Trained and Board Certified. Dr Page serves as a Team Physician for the Mustang football team at Lakewood Ranch High School. The commitment of Sarasota Orthopedic Associates is to get our patients back on their feet, back to work, back in the game, and back to life. For an appointment go to our website at www.SOA.md or call 941-951-2663.

What’s That Sound? SNAP, CRACKLE, POP

knuckle cracking

It’s a question most orthopedic surgeons get asked on a daily basis: “My joint pops…is that normal?” Like most things in life, if it’s not broke (or hurting), don’t fix it. An acute injury resulting in an audible “pop” is different from a situation such as a hip “popping” for years. Popping, cracking, or crunching of joints is quite common and often nothing to be too concerned with, especially if it is not causing discomfort or affecting one’s activities. Here are some need to know tidbits on joint popping and cracking.

What Causes This?

  • Numerous theories and causes exist including ligament stretching, tendons snapping, nerves subluxing, or bubbles forming within the joint. A recent study investigated the bubble theory using MRI videos to propose the mechanism by which “cracking” your knuckles results in a negative-pressure event which draws synovial fluid into the joint, thus leading to the subsequent pop. Why does it feel good to crack a knuckle? Thoughts are that the pressure phenomenon within/around the joints stimulates certain receptors which allows for muscles to relax. Another theory suggests natural painkillers (endorphins) are released with such activity, which may explain why it can be a difficult habit to break.
  • Other things must also be taken into account when discussing the cause of noise around a joint, such as prior injuries, surgeries, hardware/implants around the joint, and other accompanying symptoms. It is quite common for someone who injures their ACL to feel or hear a “pop” from the ligament rupturing. This must be taken in a different context from the chronic, painless popping that someone may experience around their knee cap from soft-tissue issues.
  • Lastly, arthritis can commonly be accompanied with crunching or cracking sensations and as long as it is not resulting in increasing pain or swelling, it is something that can be observed. Some older style knee/hip implants may result in noises (e.g. squeaking), and if you were experiencing this, it would likely be best to visit with your orthopedic surgeon to check the status of things and make sure the components were not wearing out in an abnormal fashion.

Should I Be Concerned?

In general, if the popping/cracking around a joint is not causing pain or swelling to occur or interfering with your function or activities, there shouldn’t be much concern. Studies have looked at whether or not cracking your knuckles would lead to arthritis, and to date, no such correlation has been shown. That said, it is generally recommended that one not perform such activities too frequently or on purpose as there have been reports of joints/knuckles becoming loose from habitual cracking. In addition, habitual knuckle crackers have been shown to develop hand swelling (not from arthritis) and decreased grip strength which can lead to decreased manual function. Nodules can also form from such activity, and this may cause cosmetic concerns for certain patients.

Common Areas to Experience It

Any joint can develop it, but perhaps the most common areas to experience it are in the hands, knees, spine, and shoulders.

  • As already mentioned, knuckle cracking is a common occurrence.
  • With regards to the knee, the anterior aspect often experiences popping/crunching from the patellofemoral joint (knee cap). This can be from mild softening of the joint, but most of the time it is from soft-tissues in the area (e.g. plica, fat pad) that simply release themselves during motion.
  • Similar to the knuckles in the hand, the facet joints and other muscles/ligaments around the spine are prone to popping.
  • The spine is a complex unit with numerous muscles, joints, discs, and ligaments contributing to its stability. Chiropractors make a living out of therapeutically popping, cracking, and aligning patients’ backs, so why would you get too concerned with your back popping if you’re not having any discomfort with it?
  • Lastly, the AC joint of the shoulder almost always develops arthritis, but rarely causes too much pain or functional limitation. Popping over this portion of the shoulder with no other symptoms is quite common. On the contrary, patients with symptomatic instability or arthritis in the shoulder joint proper will almost always have pain or issues with their function accompanying this, and would thus be treated differently to the above mentioned scenarios.

Summary

Painless popping around joints is an issue that one should hardly ever get too concerned with. If popping occurred from an acute injury or there were other symptoms being experienced in addition to it, then a visit with your orthopedic surgeon would be recommended at that point. Otherwise, keep up what you are doing and don’t let some painless noise around a joint stress you out.

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Trevor Born, MD is an orthopedic surgeon with a specialty in sports medicine. At Sarasota Orthopedic Associates our commitment is to get our patients back on their feet, back to work, back in the game, and back to life. We have four convenient locations and offer same day appointments when needed. Visit our website at www.SOA.md or call us at 941-951-2663 for an appointment. Appointments may also be made via our website.

 

TEXT NECK … Is that really a “thing”?

texting adults

Indeed it is. Think about it. We spend much of our day with our heads lowered to read our smartphones. It’s not unusual to see people “text-walking” or worse, driving while texting. With all the advantages of having a world of information at our fingertips, there is also an associated health risk.

There are over 4 billion mobile devices in the world and the average American usage is 2.7 hours per day communicating on these devices. It’s no wonder we have sore necks and shoulders. In fact, it’s becoming an epidemic affecting millions and it’s growing.

Constant lowering of the neck to look downward puts the spine in an unnatural curve that can cause reduction in the cervical spine, thus creating a “pain in the neck”. Worse, that pain can radiate through the shoulders, creating tension, and even debilitating headaches. As the situation intensifies, the arms may become weak, numb, or tingle. Over time, this pattern can become lingering and as a result, a challenge to treat.

The average head weighs about 10 pounds. When tilted downward 15 degrees, the force of your head on your cervical spine increases to about 25 pounds. The more tilt, the more weight; that can be up to as much as 60 pounds of force on your neck. Prolonged tilting downward creates excessive strain causing stress injury. Over a long period of time it may even lead to spinal misalignment, early onset of arthritis, disc compression, or nerve damage.

text neck

So how do we combat this growing concern? Resistance and strengthening are keys to reinforce the neck and shoulder muscles and offset damage. Taking frequent breaks, maintaining good posture, and doing neck stretches help circumvent damage. Most important, when using a mobile device, place it at eye level to avoid tilting of the neck. Remember … Hold Your Head Up!

If you believe you have “text neck” or any form of musculoskeletal pain, Sarasota Orthopedic Associates has four convenient locations to help you alleviate your discomfort. We offer same day appointments when needed. Give us a call at 941-951-2663 (BONE) or check our website here for more information.

 

Sources:   WFLA; LA Times; Today Health & Wellness

Time Out with Johnny Gibbs, MD

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Our weekly blogs have given us fascinating insight to the more personal side of our SOA physicians. This week we sat down with Johnny Gibbs, MD, a Fellowship Trained, Board Certified Sports Medicine Physician, and learned a bit more about what makes him tick.

What inspired you to become a physician?

I originally started my career as a physical therapist, and learning more about disease processes, I developed a strong interest in medicine.  During my first year as a physical therapist, a young patient of mine, Claire, passed away from what seemed to be medical complications of her disease.  She was a young woman, in her thirties, a single mother, and wonderful person.  I will never forget how helpless I felt over her passing and as a result, was compelled to pursue medicine to help improve patient outcomes.

Why orthopedics?

My original interest in sports medicine and rehabilitation was sparked when I was a patient myself during high school.  That, along with a background in physical therapy, made it an obvious decision for me.

What do you love most about your job?

I love that I’m able to give people their active life back and alleviate their pain.   And, of course, I love the detail and intricacy of operating!

Gibbs with girl in cast   Gibbs surgery

What is your biggest challenge?

Trying to meet patient expectations while dealing with the constantly evolving challenges of the healthcare environment is an enormous task. At times our hands may appear to be temporarily tied as a result of changes in healthcare and insurance. I want patients to know I am their advocate.

If I weren’t an orthopedic physician I’d be a __________________.

That’s easy … If I weren’t an orthopedic physician I’d be a football coach.

Your proudest moment?

Even easier answer … Becoming a father to my children.

Where is the most interesting place you’ve travelled? Why?

Bamberg, Germany, a small picturesque town famous for its smoked beer. Why? It’s delicious!

Any hobbies? Activities?

I love sports, watching ESPN, exercising, golfing, and spending time outdoors with my children.

What’s your next adventure?

My wife and I are going on a European river cruise to celebrate her graduation from dermatolopathology training.

Your guilty pleasure food?

Chocolate chip cookies and preferably Otis Spunkmeyer.

NOTE:  Dr Gibbs is a board certified, fellowship trained orthopedic surgeon at Sarasota Orthopedic Associates with a specialty in sports medicine.  You may read his professional bio by visiting our website or clicking here. SOA has 13 physicians in four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and offers same day appointments when needed.

One-on-One with Trevor Born, MD

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The past few weekly blogs have provided insight to our physicians on a personal level with our one-on-one interviews.  This week, we sit down with Trevor Born, MD, who is Fellowship Trained in Sports Medicine. Dr Born is a Bradenton native with impressive local accolades and we’re so pleased he returned to Florida after completing his medical education.

What inspired you to become a physician?

A couple reasons: Seeing the positive role physicians have in their patients’ lives, including my family members. Also knowing that physicians are constantly challenged and driven to continue the learning process not only for themselves but to further advance their patient care abilities.

Why orthopedics?

Why not? I was mainly drawn to orthopedics from my love for sports. I always thought, “Man, how awesome would it be to be the team doc for the Gators?” Coupled with the fact that building, architecture, and math were always passions of mine, the decision to pursue Orthopedics was a pretty easy one for me to make.

What do you love most about your job?

Establishing relationships with patients as I treat them for their chronic conditions or as they proceed on their journey to recovery from a serious injury. That about sums it up.

What is your biggest challenge?

Following Gator sports too much and their recent struggles? Really though, the most difficult struggle in today’s medical landscape is finding more time to care for and get to know my patients.

If I weren’t an orthopedic physician I’d be an ________

Architect, teacher, or musician.

Your proudest moment?

That would be whenever I receive a letter from a patient or their family members letting me know how thankful they were for the care I provided.  Not many other moments out there make me feel as thankful and proud of my role as a physician.

Where is the most interesting place you’ve travelled?  Why?

Yellowstone National Park. The natural wonders and wildlife, scenery, volatile terrain, and how much of it is still truly unknown makes it pretty interesting in my mind.

Any hobbies?  Activities?

Guitar/music as I have been playing since middle school and there is never a party that could not benefit from a little guitar. When I have the chance I like following Gator sports and continuing to play golf, basketball, and tennis.

What’s your next adventure?

Starting a family.

Your guilty pleasure food?

Dark chocolate.

NOTE: Trevor Born, MD is Fellowship Trained in Sports Medicine with a specialty in upper and lower extremities. You may read his professional medical biography by clicking here.  Dr Born is one of 13 SOA physicians in four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton). Sarasota Orthopedic Associates offers same day appointments when needed.  Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

GETTING TO KNOW YOU –Michael Gordon, MD

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Over the next several weeks we’ll be asking each of our physicians to reveal a more personal side that extends beyond their medical biography. This week, we spoke with Dr Michael Gordon, who is Fellowship Trained and Board Certified in treating hands, wrists, shoulders, and elbows and sees adults and children of all ages.

What inspired you to become a physician?

I wanted to be able to help people in a tangible and meaningful way. I enjoyed creating and tinkering with and fixing things as a child. You could say I was the neighborhood mechanic. I even built a boat with my father as a summer project.

Why orthopedics?

It’s most similar to architecture, mechanics, and carpentry, and, provides gratification of fixing or restoring function to the anatomy. When I considered applying to medical school, I shadowed an orthopedic surgeon and watched him return the ability of walking to people. It was very inspiring.

What do you love most about your job?

Seeing the faces of joy and gratitude when patients have recovered from their injury or condition.

What is your biggest challenge?

Not having enough time.

If I weren’t an orthopedic physician I’d be a ________.

Rock Star

Editorial Note:  Dr Gordon plays guitar and sings in the band “McDreamy and the Anatomy”, a group consisting solely of physicians! The band competed at the “DR IDOL” fundraising event for Boys & Girls Club a few years ago when they rocked the crowd and won the title.

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Your proudest moment?

Becoming and being a father to two amazing daughters.

Where is the most interesting place you’ve travelled?  Why?

I’m not fond of trying to name the “best”, “favorite”, or “most” because there are so many great places. I would say Thailand, Japan, and Israel were culturally interesting, but Europe is wonderful too. The US has amazing resources that we sometimes forget like the Grand Canyon and Yosemite.

Any hobbies?  Activities?

Music, Music, Music. Exercise has also become a central part of my life.

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What’s your next adventure?

I’d like to make it to the Great Barrier Reef for scuba diving. I haven’t made definite plans, but it’s on my list. Also the Red Sea.

Your guilty pleasure food?

Cheetos.

You can read Dr Gordon’s professional biography by clicking here.  Michael Gordon, MD is one of thirteen physicians at Sarasota Orthopedic Associates.  With three locations and same day appointments, our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

TENNIS ANYONE?

tennis racket and ball

Tennis is one of the more popular sports on the Gulf Coast of Florida. Year round competition at all levels can unfortunately lead to various “overuse” injuries, and some athletes may even sustain acute traumatic injuries which may force them to miss time. An overview of common injuries as well as ways of preventing and treating them may help to keep a tennis player on the court.

Tennis Elbow

Perhaps the most dreaded of all the overuse conditions is “Tennis Elbow,” or lateral epicondylitis. A degenerative process affecting the tendons on the lateral aspect of the elbow, which help to bend the wrist backwards, it is commonly seen in tennis players given that these muscles help resist impact when the racquet strikes the ball. Combined with their importance in gripping the handle, these muscles/tendons are prone to overuse if not properly prepared. Strengthening, a regular warm-up routine, and paying attention to grip size can help minimize the risk of developing the condition. Treatment often includes rest, therapy, braces, medications, and injections. While most cases improve with these conservative measures, occasionally surgery is needed.

Shoulder Injuries

The shoulder, like the elbow, is also predisposed to overuse injuries in tennis players. The serve is a complex motion that not only requires a balance of muscle coordination around the shoulder, but good core and lower extremity flexibility and strength to minimize risk of injury. The rotator cuff muscles can often become fatigued or weak, which can throw off the balance, and irritate surrounding tissues. The tendons and surrounding bursa can become inflamed, which may affect one even off the court. Again, conservative treatment is often all that is needed, not only focusing on the shoulder, but providing a total body program to minimize the stress on the shoulder during strokes. If symptoms persist, then further imaging and possible surgery may be needed, especially if a rotator cuff tear is present.

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Lower Extremity Injuries

The legs are just as important as one’s arms on the tennis court. Rapid changes of direction, sudden stopping and acceleration, and jumping are often needed during a match. Muscle strains, knee and ankle sprains, and stress injuries can occur during these movements. Strains, such as “pulling” a hamstring or calf muscle, can often be prevented by adequate stretching prior to playing. An awkward step or twisting episode may result in a sprain. Ankle sprains almost always improve with conservative measures, but recurrent sprains may result in continued instability and require surgery. Knee sprain treatment depends on what is injured. While certain ligament and tendon issues around the knee can heal with non-operative treatment, meniscal and ACL tears often need surgery, but this is determined on a patient-to-patient basis.  Quickly increasing the amount of tennis one is playing may predispose them to a stress fracture, either in the lower leg or foot. These require rest and off-loading of the limb, possibly with the assistance of crutches. Lastly, proper footwear is vital to the health of the lower extremities and minimizing the risks of these conditions.

Summary

Understanding the spectrum of conditions that can affect tennis players is often a good first step into learning ways to avoid them. Every patient/athlete is unique and working with them through their condition in a customized approach will best enable them to get back in the game.

Trevor Born, MD  is a Sports Medicine Physician at Sarasota Orthopedic Associates treating upper and lower extremities with non-surgical treatment as well as minimally invasive options. Click HERE for more information.